MEDICARE: DR. JULIA ANN SMITH LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	001019	MO
2	101YP2500X	Professional Counselor	10570	CA

General Provider Information

NPI Number	:	1033350871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIA ANN SMITH LPCC

Provider Business Mailing Address
First Line	:	798 LIGHTHOUSE AVE # 191
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-1010
Country	:	US
Telephone Number	:	619-866-9620
Fax Number	:

Provider Business Practice Location Address
First Line	:	2855 TELEGRAPH AVE STE 515
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94705-1151
Country	:	US
Telephone Number	:	831-264-7361
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2009
Last Update Date	:	10/11/2022

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